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Example text

15) and the liver itself provides an excellent acoustic window on to the various organs and great vessels situated in the upper abdomen. 1 Longitudinal section (LS) through the right lobe of the liver. The renal cortex is slightly less echogenic than the liver parenchyma. superior margin of the liver and is best demonstrated when surrounded by ascitic fluid. 15). The ligamentum venosum separates the caudate lobe from the rest of the liver (Fig. 6). The size of the liver is difficult to quantify, as there is such a large variation in shape between normal subjects and direct measurements are notoriously inaccurate.

Its distinctive appear- A ance allows the diagnosis to be made easily, whether or not stones are present. Cholecystectomy is performed in symptomatic patients, usually those who also have stones. 19 Adenomyomatosis: (A) LS demonstrating a thickened gallbladder wall with a small Rokitansky-Aschoff sinus (arrow) at the fundus. (B) TS demonstrating a stone and comet-tail artifacts from within the wall due to crystal deposits. (C) TS through a more advanced case of adenomyomatosis with a large Rokitansky–Aschoff sinus, giving the appearance of a ‘double lumen’.

The veins can be seen on colour Doppler to be predominantly blue with a brief red flash during atrial contraction. Various factors cause alterations to this waveform: heart conditions, liver diseases and extrahepatic conditions which compress the liver, such as ascites. Abnormalities of the hepatic vein waveform are therefore highly unspecific and should be taken in context with the clinical picture. As you might expect, the pulsatile nature of the spectrum decreases towards the periphery of the liver, remote from the IVC.

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